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Ultrafine grained (UFG) and nanostructured steels have gained attention in the last years because of the possibility of improving both strength and ductility, but also because of their potential for improving several properties in metal applications which allows replacing some conventional steels. The refinement of the microstructure obtained through Severe Plastic Deformation (SPD) has allowed for the improvement of mechanical properties and the performing of several studies related to corrosion control, mitigation, and protection. In this review, the corrosion behavior of ultra-fine grained (UFG) steels is presented regarding the existing literature and the microstructural changes produced through different SPD processes. A focus is placed on the importance of the processes for grain refinement and microstructural changes and, therefore, on the corrosion behavior. [ABSTRACT FROM AUTHOR]

The development of the Medicare Access and the Children's Health Insurance Program Reauthorization Act of 2015 (MACRA) was ultimately the result of the Centers for Medicare and Medicaid Services (CMS) [...]

Metastasis causes most cancer deaths, but is incompletely understood. MicroRNAs can regulate metastasis, but it is not known whether a single miRNA can regulate metastasis in primary cancer models in vivo. We compared the expression of miRNAs in metastatic and nonmetastatic primary mouse sarcomas and found that microRNA-182 (miR-182) was markedly overexpressed in some tumors that metastasized to the lungs. By utilizing genetically engineered mice with either deletion of or overexpression of miR-182 in primary sarcomas, we discovered that deletion of miR-182 substantially decreased, while overexpression of miR-182 considerably increased, the rate of lung metastasis after amputation of the tumor-bearing limb. Additionally, deletion of miR-182 decreased circulating tumor cells (CTCs), while overexpression of miR-182 increased CTCs, suggesting that miR-182 regulates intravasation of cancer cells into the circulation. We identified 4 miR-182 targets that inhibit either the migration of tumor cells or the degradation of the extracellular matrix. Notably, restoration of any of these targets in isolation did not alter the metastatic potential of sarcoma cells injected orthotopically, but the simultaneous restoration of all 4 targets together substantially decreased the number of metastases. These results demonstrate that a single miRNA can regulate metastasis of primary tumors in vivo by coordinated regulation of multiple genes., Introduction Metastatic disease remains the primary cause of mortality for cancer patients, despite decades of important advances in cancer research (1). To spread to distant sites, tumor cells must locally [...]

Background: There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI‐RADS) (LR)‐M lesions. Purpose: To compare overall survival (OS) and progression free survival (PFS) between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) meeting LR‐M criteria and to evaluate factors associated with prognosis. Study Type: Retrospective. Subjects: Patients at risk for HCC with at least one LR‐M lesion with histologic diagnosis, from 8 academic centers, yielding 120 patients with 120 LR‐M lesions (84 men [mean age 62 years] and 36 women [mean age 66 years]). Field Strength/Sequence: A 1.5 and 3.0 T/3D T1‐weighted gradient echo, T2‐weighted fast spin‐echo. Assessment: The imaging categorization of each lesion as LR‐M was made clinically by a single radiologist at each site and patient outcome measures were collected. Statistical Tests: OS, PFS, and potential independent predictors were evaluated by Kaplan–Meier method, log‐rank test, and Cox proportional hazard model. A P value of <0.05 was considered significant. Results: A total of 120 patients with 120 LR‐M lesions were included; on histology 65 were HCC and 55 were iCCA. There was similar median OS for patients with LR‐M HCC compared to patients with iCCA (738 days vs. 769 days, P = 0.576). There were no significant differences between patients with HCC and iCCA in terms of sex (47:18 vs. 37:18, P = 0.549), age (63.0 ± 8.4 vs. 63.4 ± 7.8, P = 0.847), etiology of liver disease (P = 0.202), presence of cirrhosis (100% vs. 100%, P = 1.000), tumor size (4.73 ± 3.28 vs. 4.75 ± 2.58, P = 0.980), method of lesion histologic diagnosis (P = 0.646), and proportion of patients who underwent locoregional therapy (60.0% vs. 38.2%, P = 0.100) or surgery (134.8 ± 165.5 vs. 142.5 ± 205.6, P = 0.913). Using multivariable analysis, nonsurgical compared to surgical management (HR, 4.58), larger tumor size (HR, 1.19), and higher MELD score (HR, 1.12) were independently associated with worse OS. Data Conclusion: There was similar OS in patients with LR‐M HCC and LR‐M iCCA, suggesting that LR‐M imaging features may more closely reflect patient outcomes than histology. Evidence Level: 3 Technical Efficacy: Stage 5 [ABSTRACT FROM AUTHOR]

A 2016 survey from Deloitte found that half of physicians were unaware of important changes to the Medicare reimbursement policy that were set to begin on January 1, 2017, and [...]

Introduction: Current standard of care for most intermediate and high‐grade soft‐tissue sarcomas (STS) includes limb‐preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few studies that attempt to correlate histopathologic response to NRT with oncologic outcomes in patients with STS. Methods: Using our institutional database, we identified 58 patients who received NRT followed by surgical resection for primary intermediate or high‐grade STS and 34 patients who received surgical resection without NRT but did receive adjuvant radiation therapy or did not receive any radiation therapy. We analyzed four histologic parameters of response to therapy: residual viable tumor, fibrosis/hyalinization, necrosis, and infarction (each ratiometrically determined). Data were stratified into two binary groups. Unadjusted, 5‐ and 10‐year overall survival, and relapsed‐free survival (RFS) were calculated using the Kaplan–Meier method. Results: Analysis of pathologic characteristics showed that patients treated with NRT demonstrate significantly higher tumor infarction, higher tumor fibrosis/hyalinization, and a lower percent viable tumor compared with patients not treated with NRT (p < 0.0001). Based on Kaplan–Meier curve analysis and multivariate cox proportional hazard model for OS and RFS, patients treated with NRT and showing >12.5% tumor fibrosis/hyalinization have significantly higher overall survival and recurrence‐free survival at 5 and 10 years. Discussion and Conclusion: We have identified three histopathologic characteristics—fibrosis, hyalinization, and infarction—that may serve as predictive biomarkers of response to NRT for STS patients. Future prospective studies will be needed to confirm this association. [ABSTRACT FROM AUTHOR]

Small bowel duplications are congenital structures commonly lined by heterotopic gastric or pancreatic mucosa. Though benign in children, small bowel duplications have the potential for malignant degeneration in adulthood. Here, we present the first reported case of metastatic adenocarcinoma arising from a small bowel duplication lined by gastroesophageal mucosa. The cancer demonstrated overexpression of the HER2/neu oncoprotein and amplification of the HER2/neu gene. This represents the only report of HER2 overexpression in this type of lesion. The patient is being treated with traditional chemotherapeutic agents in addition to monoclonal antibody therapy directed at the HER2 protein, and has demonstrated a clinical benefit from treatment. This case demonstrates that the anatomic location of a mass may be distinct from its biological origin, and this difference may have important practical implications for diagnostic testing and treatment. (Arch Pathol Lab Med. 2014;138:428-431; doi: 10.5858/arpa.2012-0523-CR), A 51-year-old man with a remote history of perforated colonic diverticulitis presented to the emergency department with 2 days of abdominal pain and bloody stools. A computed tomography scan revealed [...]